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    • LIC-Product Profile:1. Health protection plusIntroduction:IN THIS POLICY, THE INVESTMENT RISK IN INVESTMENT PORTFOLIO IS BORNEBY THE POLICYHOLDERHealth is a major concern on everybody’s mind these days. With sky rocketing medicalexpenses, the possibility of any illness leading to hospitalization or surgery is a constant sourceof anxiety unless the family has actively provided for funds to meet such an eventuality. Mostfamilies rarely provide for healthcare, and even if they do, it is grossly inadequate. Given thisscenario, LIC has launched LIC?s Health Protection Plus plan, a unique long term healthinsurance plan that can combine health insurance covers for the entire family (husband, wifeand the children) ? Hospital Cash Benefit (HCB) and Major Surgical Benefit (MSB) along witha ULIP component (investment in the form of Units) that is specifically designed to meetDomiciliary Treatment Benefit (DTB) / Out Patient Department (OPD) expenses for theinsured members.I. Vital InformationAccumulation period1.Age Principal Insured Spouse Insured Child InsuredMin Policy Entry Age ? Age Last 18 18 3monthsBirthdayMin Age ? HCB Cover ? Age Last 18 18 3monthsBirthdayMin Age ? MSB Cover ? Age Last 18 18 18BirthdayMaximum Entry Age Age Nearest 55 55 17
    • BirthdayII Premium Payment.Mode of Payment: Yearly, Half-Yearly & Monthly (ECS Mode only)Minimum Annual Premium ConditionsNumber of Lives Higher of the two conditions in each category listed below:coveredSingle Life 6 times the HCB of the Principal Insured OR Rs.5000 p.a. The arithmetic sum of 6 times the HCB of PI and 3 times the HCB of theTwo Lives second insured. OR Rs.7500 p.a.More than two The arithmetic sum of 6 times the HCB of PI and 3 times the HCB of eachLives of the others insured OR Rs.10,000 p.a.Annualized Premiums are payable in multiples of Rs.500.III. Sum Assured.The Principal Insured must first choose the respective levels of HCB for each member to becovered under the policy. The sum assured for major surgical benefits will be 200 times of theHCB you choose. Principal Insured Spouse Insured Child InsuredMajor Surgical 200 times the HCB applicable to each insured lifeSum Assured under the policy.IV. Other Terms of the Policy.Age Nearest Birthday Principal Insured Spouse Insured Child InsuredMax. HCB and MSB 75 75 25Cover ceasing agePremium Ceasing Age 65 Years Nearest Birthday of the Principal
    • InsuredDTB ceasing age No age limit No age limit 25V. Addition of New Members. It is important for the Principal Insured (the person taking thepolicy) to decide which of the existing family members are to be covered and include them atthe beginning (proposal stage) itself. Eligible existing family members cannot be added at alater stage. New members can however be added under the following three situations.Situation When to include? The cover starts fromMarriage/remarriage of Within one year from thethe Principal insured The following policy anniversary date of marriageafter taking the policyA Child born or Legally Health Cover starts from the policyadopted child less than 3 anniversary falling immediately aftermonths after taking the the child completes 3 monthspolicyLegally adopted child is From the policy anniversary fallingmore than 3 months old after date of adoption The new members will be eligible for the cover only if they satisfy the conditions ofminimum premium and benefits. New members must be included by the Principal Insured only. No new members will beallowed after the death of the principal insured.VI. Increase/Decrease of Premiums. Increase or decrease of premiums is allowed during theterm of the policy. Increase in premium must be in multiples of Rs.500. In case of decrease, theminimum premium conditions must be satisfied. However, increase/decrease in premiums doesnot affect the level of health cover and HCB and MSB benefits.II. CONDITIONS & RESTRICTIONS
    • 1. Premium Discontinuance and Revival. The policy will lapse if the premiums are not paidwithin the days of grace. The PI shall have the option to revive the policy any time within aperiod of two years from the due date of first unpaid premium by payment of arrears ofpremiums or by availing Premium Holidays. During the period of discontinuity, the charges forHCB and MSB covers will continue to be deducted (even beyond two years) from the policyfund till:i. The policy fund has sufficient balance, orii. The lives covered reach the benefit ceasing age, oriii. The maximum lifetime benefits are exhausted, oriv. The policy is terminated due to death or any other reason, if any,whichever is earlier.In case the policy is not revived during the revival period and the balance in the Policy Fund isnot sufficient to recover the charges i.e. if the Policy Fund exhausts, the policy shallcompulsorily be terminated with a notice to the PI.All other charges will also continue to be deducted from the Policy Fund till the fund exhausts.2. Premium Holidays. If the policy lapses after at least 3 years’ premiums have been paid thePrincipal Insured has the option of either paying all the due premiums in full or avail ofpremium holiday by just paying the latest instalment premium without any interest. Thepremium holidays can be availed only as long as the policy fund has a balance of at least oneannualized premium at the time of revival.3. Surrender. No surrender will be allowed.4. Policy Loans. No policy loan will be available under this policy.5. Assignment. No assignment will be allowed under this policy.6. Tax Benefit. The premium payable under this product is eligible for Section 80(D) benefit of
    • Income Tax Act, 1961.7. Risks borne by the Policyholder:i) LIC’s Health Protection Plus is a Unit Linked Health Insurance product which is differentfrom the traditional insurance products and is subject to risk factors.ii) The premium paid in Unit Linked Life Insurance policies are subject to investment risksassociated with capital markets and the NAVs of the units may go up or down based on theperformance of fund and factors influencing the capital market and the insured is responsiblefor his/her decisions.iii) Life Insurance Corporation of India is only the name of the Insurance Company and LIC’sHealth Protection Plus is only the name of the unit linked health insurance contract and doesnot in any way indicate the quality of the contract, its future prospects or returns.iv) Please know the associated risks and the applicable charges, from your Insurance agent orthe Intermediary or policy document of the insurer.v) The fund offered under this contract is the name of the fund and do not in any way indicatethe quality of these plans, their future prospects and returns.vi) All benefits under the policy are also subject to the Tax Laws and other financialenactments as they exist from time to time.8. Cooling off period: If you are not satisfied with the ?Terms and Conditions? of the policy,you may return the policy to us within 15 days.III.EXCLUSIONS1. Common Exclusions in respect of HCB & MSB Benefits: No benefits are availablehereunder and no payment will be made by the Corporation for any claim for Hospital CashBenefit and Major Surgical Benefit under this Policy on account of Hospitalization directly orindirectly caused by, based on, arising out of or howsoever attributable to any of the following:a.“Pre-existing condition”- any medical condition or any related condition (e.g. illnesses,symptoms, treatments, pains and surgery) that have arisen at some point prior to the
    • commencement of this coverage, irrespective of whether any medical treatment or advice wassought. Any such condition or related condition about which the PI or insured dependant know,knew or could reasonably have been assumed to have known, will be deemed to be pre-existing. The following conditions will also be deemed to be “pre-existing”:i. Conditions arising between signing the application form and confirmation of acceptance bythe Corporation.ii. Any Sickness, illness, complication or ailment arising out of or connected to the pre-existingillnessb. Any Sickness that has been classified as an Epidemic by the -Central or State Government.c. Self afflicted injuries or conditions (attempted suicide), and/or the use or misuse of any drugsor alcohol.d. Any sexually transmitted diseases or any condition directly or indirectly caused to orassociated with Human Immuno Deficiency (HIV) Virus or any Syndrome or condition of asimilar kind commonly referred to as AIDS.e. War, invasion, act of foreign enemy, hostilities (whether war be declared or not), civil war,rebellion, revolution, insurrection military or usurped power of civil commotion or loot orpillage in connection herewith.f. Naval or military operations(including duties of peace time) of the armed forces or air forceand participation in operations requiring the use of arms or which are ordered by militaryauthorities for combating terrorists, rebels and the like.g. Any natural peril (including but not limited to avalanche, earthquake, volcanic eruptions orany kind of natural hazard).h. Participation in any hazardous activity or sports including but not limited to racing, scubadiving, aerial sports, bungee jumping and mountaineering or in any criminal or illegalactivities.i. Radioactive contamination.j.Non-allopathic methods of surgery and treatment.2. Additional Exclusions in respect of Hospital Cash Benefit:No benefits are available hereunder and no payment will be made by the Corporation for anyclaim for Hospital Cash Benefit under this Policy on account of Hospitalization directly or
    • indirectly caused by, based on, arising out of or howsoever attributable to any of the following:a.Hospitalization due to illness within the first 180 days from the Date of Covercommencement or 90 days from the date of revival/reinstatement if revived afterdiscontinuance of the cover.b.Removal of any material that was implanted in a former surgery before Date of Covercommencementc.Any diagnosis or treatment arising from or traceable to pregnancy (whether uterine or extrauterine), childbirth including caesarean section, medical termination of pregnancy and/or anytreatment related to pre and post natal care of the mother or the new born.d.Hospitalization for the sole purpose of physiotherapy or any ailment for which hospitalizationis not warranted due to advancement in medical technologye.Any treatment not performed by a Physician or any treatment of a purely experimental nature.f.Any routine or prescribed medical check up or examination.g.Medical Expenses relating to any hospitalization primarily for diagnostic, X-ray or laboratoryexaminationsh.Circumcision, cosmetic or aesthetic treatments of any description, change of gender surgery,plastic surgery (unless such plastic surgery is necessary for the treatment of Illness orAccidental Bodily Injury as a direct result of the insured event and performed with in 6 monthsof the same).i.Hospitalization for donation of an organ.j.Hospitalization for correction of birth defects or congenital anomaliesk.Dental treatment or surgery of any kind unless necessitated by Accidental Bodily Injury.l.Convalescence, general debility, nervous or other breakdown, rest cure, congenital diseases ordefect or anomaly, , sterilization or infertility (diagnosis and treatment), any sanatoriums, spaor rest cures or long term care or hospitalization undertaken as a preventive or recuperativemeasure.3. Additional Exclusions in respect of Major Surgical Benefit:No benefits are available hereunder and no payment will be made by the Corporation for anyclaim for Major Surgical Benefit under this Policy directly or indirectly caused by, based on,arising out of or howsoever attributable to any of the following:
    • a.Surgeries not listed in the Surgical Benefit Annexure Ib.Surgery triggered by health related causes (and not by Accident) within the first 180 daysfrom the commencement date or 90 days from the date of revival/reinstatement if revived afterdiscontinuance of the cover.c.Any Surgery for which claim has already been made and paid by the Corporation.d.Any treatment not performed by a Physician/Surgeon.e.Any treatment including Surgery that is performed un-conventionally under experimentalconditions and purely experimental in nature.f.Circumcision, cosmetic or aesthetic treatments of any description, change of life surgery ortreatment, treatment (including surgery) for obesity, plastic surgery (unless necessary for thetreatment of Illness or accidental Bodily Injury as a direct result of the insured event andperformed with in 6 months of the same).g.Surgery for donation of an organ.h.Removal or correction or replacement of any material that was implanted in a former Surgerybefore Date of Cover commencementi.Surgery for correction of birth defects or congenital anomalies.j.Any diagnosis or treatment or surgery arising from or traceable to pregnancy (whether uterineor extra uterine).IV. INVESTMENT OF FUNDSThe premiums allocated to purchase units will be strictly invested in a Health Protection PlusFund, SFIN No: ULIF001290409LICHPR+FND512 (Income and Growth – Low Risk) asfollows:A. Government/ Government Guaranteed/ Corporate Not less than 50%Securities/ DebtB. Short term investments: Money Market instruments Not more than 90%including A above Not less than 10% & NotC. Investment in listed equity shares more than 50%
    • 1. Method of Calculation of Unit price: Units will be allotted based on the Net Asset Value(NAV) on the date of allotment. There is no Bid-Offer spread. The NAV will be computed onday to day basis and will be based on investment performance and Fund Management Chargeand shall be computed as:Market value of investment held by the fund + Value of Current Assets – Value of CurrentLiabilities & Provisions, if any_______________________________________________________________________________Number of Units existing on Valuation Date (before creation / redemption of Units)a. Applicability of Net Asset Value (NAV): The premiums received up to 3 p.m. (as perIRDA guidelines) by the servicing branch of the corporation by a local cheque or by a demanddraft payable at par at the place where the premium is received, the closing NAV of the day onwhich premium is received shall be applicable. The premiums received after such time by theservicing branch of the corporation by a local cheque or by a demand draft payable at par at theplace where the premium is received, the closing NAV of the next business day shall beapplicable.b. Redeeming of Units: In respect of valid applications received for reimbursement of medicalexpenses, death claim, etc up to such time by the servicing branch of the Corporation closingNAV of that day shall be applicable. For the valid applications received in respect ofDomiciliary Treatment Benefit, death claim etc after 3 p.m. (as per IRDA guidelines) by theservicing branch of the Corporation the closing NAV of the next business day shall beapplicable.2. Charges under the Plan:a. Premium Allocation Charge: This is the percentage of the premium appropriated towardscharges from the premium received. The balance known as allocation rate constitutes that partof the premium which is utilized to purchase (Investment) units for the policy. The allocationcharges are as below:
    • First year thereafter30% 6%The above allocation charges shall be applicable for all premiums including any additionalpremium paid in that particular policy year.b. Health Insurance Charge: There will be two separate charges for the following benefits:i) Hospital Cash Benefitii) Major Surgical Benefits.These charges will be taken every month in respect of all the members covered by cancelingappropriate number of units out of the Policy Fund.These charges, during a policy year, will be based on the age nearer birthday, of each of themembers covered, as at the Policy anniversary coinciding with or immediately preceding thedue date of cancellation of units and hence may increase every year on each policy anniversary.The charges will also depend on whether the person covered is male or female and standard orsub-standard as per the underwriting decision.If more than one member is covered under the policy then the total charges shall be based onthe individual ages of all the members and the amount of cover for each such member.In case of Hospital Cash Benefit, the charges will be applied on the Initial Daily Benefit asmentioned in the Policy Schedule.The charges for Hospital Cash Benefit and/or Major Surgical Benefit will not be deducted oncethe benefit terminates.Specimen charges for Rs. 100/- per day for HCB and Rs. 1000/- SA for MSB for standard livesare given as under:Age HCB MSB5 24.43 20.43 0 015 20.71 20.71 0 025 31.39 24.34 1.02 1.3835 33.59 29.96 1.58 1.7545 49.29 53.20 3.54 2.64
    • 55 76.08 72.53 7.28 5.16b. Health Insurance Charge: Rs.75 per month during the first year and Rs.Policy Administration Charges 25 per month during the subsequent years. Levied @ 1.25% per annum of the unit fund,Fund Management Charges at the time of computation of NAV which will be done on daily basis.Bid/ Offer Spread NilService Tax Charge A service tax charge shall be levied on the following charges: i)Policy Administration charge and Health Insurance charges - by canceling appropriate number of units out of the Policyholder’s Fund Value on a monthly basis as and when the corresponding Policy Administration and Health Insurance charges are deducted. ii)Premium allocation charge - at the time of allocation of premium. iii)Fund Management charge– at the time of computation of NAV on daily basis. The level of this charge will be as per the rate of service tax as applicable from time to time. Currently, the rate of service tax is 10% with an educational cess at the rate of 3% thereon and hence effective rate is 10.30%.
    • d. Right to revise charges-The Corporation reserves the right to revise all or any of the abovecharges except the Premium Allocation charge. The modification in charges will be done withprospective effect with the prior approval of IRDA.Although the charges are reviewable, they will be subject to the following maximum limit:Policy Administration Charge-Rs. 150/- per month during the first policy year and Rs.50/- permonth thereafter, throughout the term of the policy.Fund Management Charge-The Maximum for Fund will be 2.5% p.a. of Unit FundHospital Cash Cover charges and Major Surgical Benefit charges shall not exceed by more than200% of the current rate.Disclaimer : For more details on risk factors , terms and conditions please read sales brochurecarefully before concluding a sale .2. Jeevan Arogya PlanIntroductions:Health has been a major concern on everybody’s mind, including yours. In these days ofskyrocketing medical expenses, when a family member is ill, it is a traumatic time for the rest ofthe family. As a caring person, you do not want to let any unfortunate incident to affect yourplans for you and your family. So why let any medical emergencies shatter your peace of mind.LIC has launched LIC’s Jeevan Arogya, a unique non-linked Health Insurance plan whichprovides health insurance cover against certain specified health risks and provides you withtimely support in case of medical emergencies and helps you and your family remain financiallyindependent in difficult times.LIC’s Jeevan Arogya gives you:• Valuable financial protection in case of hospitalisation, surgery etc• Increasing Health cover every year• Lump sum benefit irrespective of actual medical costs• No claim benefit
    • • Flexible benefit limit to choose from• Flexible premium payment optionsVery easy to choose your planStep 1 Choose the level of Health cover you needStep 2 Work out the premium payable along with our RepresentativeStep 1: Choose the level of Health cover you need:You can choose the amount of Initial Daily Benefit (i.e. the daily Hospital Cash Benefitapplicable in the first year of the policy) as per your need from out of the following choices:` 1000 per day ` 2000 per day ` 3000 per day ` 4000 per dayThis is the amount that will be payable to you in the event of hospitalisation in the first year on aper day basis. The Major Surgical Benefit that you will be covered for will be 100 times theInitial Daily Benefit you have chosen. Thus the initial Major Surgical Benefit Sum Assured willbe ` 1 lakh, 2 lakh, 3 lakh, 4 lakh respectively. Other benefits such as Day Care ProcedureBenefit, Other Surgical Benefit and Premium waiver Benefit (PWB) mentioned below shall alsobe payable depending upon the daily Hospital Cash Benefit chosen.Step 2: Work out the premium payable along with our representativeYour premium will depend on your age, gender, the Health cover option you have chosen,whether you are Principal Insured or other insured life and the mode of payment.Tables below give an indicative annual premium, payable yearly, for all health benefitscorresponding to an Initial Daily Benefit of ` 1000 per day, for some of the ages in respect ofvarious lives that can be covered under a single policy:PRINCIPAL INSURED (Male)Age at entry Premium (`)
    • 20 1922.6530 2242.9040 2799.7050 3768.00SPOUSE (Female) / PARENT (of PI/Spouse) (Female)Age at entry Premium (`)20 1393.1530 1730.6540 2240.6050 2849.10CHILDAge at entry Premium (`)0 792.005 794.7510 812.3515 870.75Who can be insured?You (as Principal Insured (PI)), your spouse, your children, your parents and parents of yourspouse can all be insured under one policy. Quite a relief isn’t it, to have all insured under onepolicy!The minimum and maximum age at entry is as under: Minimum age at entry Maximum age at entrySelf / spouse 18 years 65 years (last birthday)
    • Parents / parents-in-law 18 years 75 (last birthday)Children 91 days 17 years (last birthday)How long are each insured under this policy?Each of the insured are covered for Health risks up to age (80). Children are insured up to age 25years.1. Payment of Premiums: You may pay premiums regularly at yearly, half-yearly, quarterly ormonthly (ECS mode only) intervals over the term of the policy.The premium in respect of each individual will be payable from the date of entry into the policytill the date of exit from the policy and will depend on the age of the insured member, the levelof Hospital Cash Benefit (HCB) chosen, whether the insured member is Principal Insured or anyother Insured life (in case of cover for more than one member in a policy). The level of premiumfor Principal Insured and the other insured members shall be different for the same age and samelevel of cover.The premiums are guaranteed for 3 years from the date of commencement of policy. Thereafteri.e. at the end of every 3 years, the Corporation reserves the right to review the premium to takeaccount of the experience of the portfolio subject to prior approval from IRDA. The ratesapplicable on every Automatic Renewal Date shall be guaranteed for a further period of 3 yearsi.e. till next Automatic Renewal Date.The premium rates in respect of each insured member on renewal will be based on age of thatmember at the time of inclusion into the policy.The total premium to be charged for a policy will be the sum of premiums in respect of eachmember to be covered in that policy.2. Mode and High HCB Rebates:Mode Rebate:Yearly mode : 2% of tabular premiumHalf-yearly mode : 1% of the tabular premium
    • HCB Rebates:In respect of a member covered under a policy, if HCB is more than ` 1000, then the premiumarrived at in respect of that member shall be reduced by an amount (`) given below:HCB (`) For PI For each insured memberother than PI2000 500 2503000 1000 5004000 1500 7503. Automatic Renewal Date: The installment premium will be guaranteed in respect of eachInsured for a period of 3 years from the Date of Commencement of the policy, i.e. for the first 3years of the policy. Thereafter, at the end of every third policy anniversary, the premiums may bereviewed to take into account the Corporation’s experience, subject to prior approval fromIRDA. These premium due dates, at the end of every third policy anniversary, starting from thedate of commencement of policy till the date of cover expiry, on which the installment premiumsare reviewable, will be referred as Automatic Renewal Dates in respect of all Insured in thePolicy.On any Automatic Renewal Date in the future, the installment premium will be based on the ageof the Insured at the time of inclusion into the policy and the Corporation’s premium rates thenprevailing for this product.4. Options:A) Cover to new additional members: If PI gets married/ remarried during the term of the policy,the spouse and parents-in-law can be included in the policy within six months from the date ofmarriage / remarriage, but the cover shall start from the policy anniversary coinciding with ornext following the date of inclusion. Enhanced premium shall be due from such policyanniversary.Similarly, Any child born/legally adopted after taking the policy can also be covered from thenext immediate policy anniversary date following the date on which the child completes the ageof 3 months. If the age of legally adopted child on the date of adoption is more than 3 months,
    • the child can be covered from policy anniversary coinciding with or next following the date ofadoption. Enhanced premiums shall be due from such policy anniversary.Inclusion of each additional member will be on payment of enhanced premiums and subject tovarious terms and conditions of the plan.Any addition of new lives shall be allowed by the PI only. After the death of PI, no addition willbe allowed.Addition in any other case will not be allowed. The existing spouse, parents, parents-in-law andchildren, if not covered at the time of taking policy, shall not be covered under the policy.If both of the parents (father and mother) are alive and are eligible for cover, then either both ofthem will have to be covered or none of them will be covered. The PI will not have any option tochoose one of them. The same condition will apply for parents-in-law also.B) Quick Cash facility: If any of the insured lives undergoes any eligible surgery covered underCategory I or II of MSB in any of the listed network hospitals, you, as PI will have an option toavail Quick Cash facility. Under this facility, 50% of eligible MSB amount would be madeavailable even during the period of hospitalization of any of the insured lives covered (thesurgery may be either planned or emergency due to accident) instead of waiting for making aclaim for the benefit after discharge. It will be only an advance payment in the event ofhospitalization for any MSB defined in the surgeries listed under categories I & II andpermissible under the policy conditions of the plan. This will be, however, subject to approvalfrom the TPA (Third Party Administrator), and the advance amount will be adjusted from thefinal settlement of MSB claim amount.This facility of advance payment could be availed by submitting your Bank Account details inthe prescribed format. The amount of advance shall be credited to your bank account directly.C) Term Assurance Rider: You, as PI, and your spouse may opt for Term Assurance asoptional rider equal to the MSB SA. In case of unfortunate death, an amount equal to Term
    • Assurance Sum Assured will be payable on death during the term for which Term AssuranceRider is opted for.D) Accident Benefit Rider: You and your spouse may also opt for Accident Benefit Rider ifTerm Assurance Rider has been opted for. Maximum Accident Benefit Sum Assured shall beequal to the Term Assurance Rider SA. In case of unfortunate death due to an accident, anamount equal to Accident Benefit Sum Assured shall be payable.Accident Benefit Rider will be available under the plan by payment of additional premium of `0.50 for every ` 1,000/- of the Accident Benefit Sum Assured per policy year in respect of eachlife to be covered.The additional premium for this benefit will not be required to be paid on and after the Policyanniversary on which the Term Assurance Rider ceases.5. Eligibility Conditions And Other Restrictions:FOR BASIC PLANi) For Hospital Cash Benefit (HCB) (under Basic Plan)Feature Principal Insured Spouse (if any) & Insured Dependent Insured (PI) Insured Parents / Parents-in- Children (if any) law (if any) 1. Minimum Initial ` 1,000/- ` 1,000/- ` 1,000/- Daily Benefit (in a ward other than Intensive Care Unit) 1. Maximum initial ` 4,000/- Insured Spouse- Less than or Less than or equal to daily amount equal to that of PI that of Insured Spouse
    • Insured Parents / Parents-in- (PI, if there is no law- Less than or equal to that of Insured Spouse). Insured Spouse (PI, if there is no Further, included Insured Spouse). Further, children shall be included parents / parents-in-law covered for equal shall be covered for equal benefits. benefits. 1. Maximum annual 30 days in year 1, 90 days per year thereafter, inclusive of stay in ICU. benefit period, Maximum number of days in ICU is restricted to 15 days in year 1 and to applicable to each 45 days thereafter. insured 1. Maximum 720 days inclusive of stay in ICU. Maximum number of days in ICU is Lifetime Benefit restricted to 360 days period, applicable to each insuredInitial Daily Benefit shall be in multiples of ` 1000/-.ii) For Major Surgical Benefit (MSB) (under Basic Plan)Feature Principal Insured Insured Spouse (if Insured Dependent (PI) any) & Insured Children (if any) Parents / parents-in- law (if any) 1. Major Surgical 100 times of Insured Spouse- 100 100 times of ADB of Benefit Sum Applicable Daily times of ADB of each child Assured (MSB Benefit (ADB) of PI Insured Spouse SA) (as specified in Para Insured Parents / 1A) above). parents-in-law- 100
    • times of ADB of each parent 1. Maximum annual 100% of Major Surgical Benefit Sum Assured benefit, applicable to each insured 1. Maximum 800% of Major Surgical Benefit Sum Assured Lifetime Benefit, applicable to each insurediii) For Day Care Procedure Benefit (DCPB) (under Basic Plan)Feature Principal Insured Insured Spouse (if Insured Dependent (PI) any) & Insured Children (if any) Parents / parents-in- law (if any) 1. Lump sum benefit 5 times of Insured Spouse- 5 5 times of ADB of each payable Applicable Daily times of ADB of child Benefit (ADB) of Insured Spouse PI Insured Parents / parents-in-law- 5 times of ADB of each parent 1. Maximum annual 3 Surgical Procedures benefit, applicable to each insured 1. Maximum Lifetime 24 Surgical Procedures Benefit, applicable to
    • each insurediv) For Other Surgical Benefit (OSB) (under Basic Plan)Feature Principal Insured Spouse (if Insured Dependent Insured (PI) any) & Insured Children (if any) Parents / parents-in- law (if any) 1. Daily benefit amount 2 times of Insured Spouse- 2 2 times of ADB of each ADB of PI times of ADB of child Insured Spouse Insured Parents / parents-in-law- 2 times of ADB of each parent 1. Maximum annual benefit, 15 days in first policy year and 45 days per year thereafter applicable to each insured 1. Maximum Lifetime 360 days Benefit, applicable to each insuredFOR ACCIDENT BENEFIT RIDER OPTION:(a) Minimum Accident Benefit Sum Assured: ` [25] in 000s(b) Maximum Accident Benefit Sum Assured: An amount equal to the Term Assurance SumAssured in respect of the insured, subject to maximum of ` 50 lakhs overall limit considering theAccident Benefit Sum Assured in respect of all existing policies under individual as well asgroup policies on the life of the insured including the policies taken from Life Insurance
    • Corporation of India and other insurance companies and the Accident Benefit Sum Assuredunder new proposals into consideration.The Accident Benefit Sum Assured shall be in multiples of ` 5,000/-.(c) Minimum Entry Age: 18 years completed(d) Maximum Entry Age: 50 years (Nearest Birthday)(e) Maximum age for cover: 60 years (Nearest Birthday)(f) Maximum term: 35 yearsFOR TERM ASSURANCE RIDER OPTION:(a) Minimum Term Assurance Sum Assured: ` [100] in 000s(b) Maximum Term Assurance Sum Assured: An amount equal to the Major Surgical BenefitSum Assured (MSB SA) at the time of inception/ inclusion into the policy (i.e. 100 times ofInitial Daily Hospital Cash Benefit) in respect of the insured, subject to the maximum of ` 25lakh overall limit taking all term assurance riders under all existing policies of the Life Assuredand Term Assurance Sum Assured under other proposals into consideration.The Term Assurance Sum Assured shall be in multiples of ` 25,000/-.(c) Minimum Entry Age: 18 years (completed)(d) Maximum Entry Age: 50 years (Nearest Birthday)(e) Maximum Maturity Age: 60 years (Nearest Birthday)(f) Maximum Term: 35 years6. Other Features:A) Death Benefit under the basic plan: No death benefits will be payable on the death of anyInsured unless any of the Rider Benefits mentioned above has been opted for.On death of the Principal Insured;a) The surviving Insured Spouse will become the Principal Insured provided the option isexercised at the beginning of the contract and the Policy will continue. In such case, the premiumfor the Insured Spouse will change from the date coinciding with or following instalment
    • premium due date and the new premium would be based on tabular premium rates applicable forPIs and the age for calculation of revised premium rate will be the age at entry of the spouse. Ifthe option is not exercised at the beginning of the contract, the Insured Spouse will not becomePI and the policy will terminate.b) If the Insured Spouse had predeceased the Principal Insured, then the other Insured will havethe option to take a new policy and the existing Policy will terminate. In respect of these otherInsured:i. The new policy will be issued without any underwriting if the new policy is bought within 90days of the termination of the existing Policy.ii. The maximum entry age condition will not apply for the new policy.iii. The outstanding Waiting periods and outstanding period of any Exclusion will however applyunder the new policy.iv. Other terms and conditions including premium rates will be as applicable for the new policy.In the event of death of an Insured person other than the Principal Insured, the policy willcontinue after removal of the Insured and change in premium will apply from the instalmentpremium due date coinciding with or next following the date of intimation of death of theInsured.B) Maturity Benefit: No benefits are payable at end of the Cover Period.C) Discontinuance of premiums: A grace period of one month but not less than 30 days will beallowed for payment of yearly or half yearly or quarterly premiums and 15 days for monthlypremiums.If premium is not paid before the expiry of the days of grace, the Policy lapses and all thebenefits payable under this plan will cease.D) Revival: A lapsed policy may be revived by the PI within a period of 2 years from the duedate of first unpaid premium but before the expiry of cover in respect of PI, on submission ofproof of continued insurability to the satisfaction of the Corporation and the payment of all thearrears of premium together with interest at such rate as may be fixed by the Corporation fromtime to time. The Corporation reserves the right to accept at original terms, accept with modified
    • terms or decline the revival of a discontinued policy. The revival of the discontinued policy shalltake effect only after the same is approved by the Corporation and is specifically communicatedto the PI.Waiting periods and Exclusions, as described in Para 14 and 15 respectively, will apply onrevival. The Principal Insured may need to provide satisfactory evidence of good health inrespect of each Insured as required by the Corporation, at his own expense. The Date of Revivalwill be when all requirements for revival/reinstatement are met and approved by the Corporationat its sole discretion.No benefit will be paid for an event that occurred during the lapse period till the Date of Revivalwhen the Policy was in a discontinued state.Further, if the Automatic Renewal Date falls between the revival period and revival is done afterthe Automatic Renewal Date, the premium before and after the Automatic Renewal Date may bedifferent.Revival will not be allowed post the revival period.E) Surrender:No surrender value will be available under the plan.7. Cooling off period:If you are not satisfied with the “Terms and Conditions” of the policy, you may return the policyto us within 15 days.8. Loan:No loan will be available under this plan.9. Assignment:No Assignment will be allowed under this plan.10. Exclusions:No benefits are available hereunder and no payment will be made by the Corporation for any
    • claim under this policy on account of hospitalization or surgery directly or indirectly caused by,based on, arising out of or howsoever attributable to any of the following:i. Any Pre-existing Condition unless disclosed to and accepted by the Corporation prior to theDate of Cover Commencement or the Date of Revival (if the Policy is revived afterdiscontinuance of the Cover).ii. Any treatment or Surgery not performed by a Physician/Surgeon or any treatment or Surgeryof a purely experimental nature.iii. Any routine or prescribed medical check up or examination.iv. Medical Expenses relating to any treatment primarily for diagnostic, X-ray or laboratoryexaminations.v. Any Sickness that has been classified as an Epidemic by the Central or State Government.vi. Circumcision, cosmetic or aesthetic treatments of any description, change of gender surgery,plastic surgery (unless such plastic surgery is necessary for the treatment of Illness or accidentalBodily Injury as a direct result of the insured event and performed with in 6 months of the same).vii. Hospitalisation or Surgery for donation of an organ.viii. Treatment for correction of birth defects or congenital anomalies.ix. Dental treatment or surgery of any kind unless necessitated by Accidental Bodily Injury.x. Convalescence, general debility, nervous or other breakdown, rest cure, congenital diseases ordefect or anomaly, sterilisation or infertility (diagnosis and treatment), any sanatoriums, spa orrest cures or long term care or hospitalization undertaken as a preventive or recuperativemeasure.xi. Self afflicted injuries or conditions (attempted suicide), and/or the use or misuse of any drugsor alcohol.xii. Any sexually transmitted diseases or any condition directly or indirectly caused to orassociated with Human Immuno Deficiency (HIV) Virus or any Syndrome or condition of asimilar kind commonly referred to as AIDS.xiii. Removal or correction or replacement of any material that was implanted in a formersurgery before Date of Cover commencement or Date of Revival (if the Policy is revived afterdiscontinuance of the Cover).xiv. Any diagnosis or treatment arising from or traceable to pregnancy (whether uterine or extrauterine), childbirth including caesarean section, medical termination of pregnancy and/or any
    • treatment related to pre and post natal care of the mother or the new born.xv. Hospitalisation for the sole purpose of physiotherapy or any ailment for which hospitalizationis not warranted due to advancement in medical technology.xvi. War, invasion, act of foreign enemy, hostilities (whether war be declared or not), civil war,rebellion, revolution, insurrection military or usurped power of civil commotion or loot or pillagein connection herewith.xvii. Naval or military operations(including duties of peace time) of the armed forces or air forceand participation in operations requiring the use of arms or which are ordered by militaryauthorities for combating terrorists, rebels and the like.xviii. Any natural peril (including but not limited to avalanche, earthquake, volcanic eruptions orany kind of natural hazard).xix. Participation in any hazardous activity or sports including but not limited to racing, scubadiving, aerial sports, bungee jumping and mountaineering or in any criminal or illegal activities.xx. Radioactive contamination.xxi. Non-allopathic methods of treatment or surgery.xxii. Participation in any criminal or illegal activities.xxiii. Treatment arising from the Insured’s failure to act on proper medical advice.Benefit:1.Benefits offered under the plan are• Hospital cash benefit (HCB)• Major Surgical Benefit (MSB)• Day Care Procedure Benefit• Other Surgical Benefit• Ambulance Benefit• Premium waiver Benefit (PWB)A) Hospital Cash Benefit: If you or any of the insured lives covered under the policy ishospitalised due to Accidental Body Injury or Sickness and the stay in hospital exceeds acontinuous period of 24 hours, then for any continuous period of 24 hours or part thereof,
    • provided any such part stay exceeds a continuous period of 4 hours (after having completed the24 hours as above) in a non-ICU ward/room of a hospital, an amount equal to the ApplicableDaily Benefit (ADB) available under the policy during that policy year shall be payable subjectto benefit limits and conditions mentioned in Para 11A) and exclusions mentioned in Para 15below.During the first year of cover commencement in respect of each insured, the Applicable DailyBenefit shall be the Initial Daily Benefit amount chosen by you and mentioned in the policySchedule.The amount of ADB for each policy year, after the first policy year, shall consist of 2 parts:An arithmetic addition of an amount equal to 5% (five percent) of the Initial Daily Benefit tothe Applicable Daily Benefit of the previous Policy Year. Such increase in the Applicable DailyBenefit shall be effected on each policy anniversary during the Cover Period and shall continueuntil it attains a maximum amount of 1.5 times the Initial Daily Benefit. Thereafter, this amountin each Policy Year in future shall remain at that maximum level attained.Further arithmetic addition of an amount equal to “No Claim Benefit” (as described in Para1.G) below) provided the policy attracts and is eligible for it. There shall be no maximum limitfor such increase which means that if this policy is eligible for “No Claim Benefit”, the sameshall be granted throughout the Cover Period without any maximum limit.For members included subsequently under the policy, the benefit in the first year shall be equalto Initial Daily Benefit amount and thereafter the Applicable Daily Benefit shall increase asabove.If any of the member insured is required to stay in an Intensive Care Unit of a hospital, two timesthe Applicable Daily Benefit will be payable subject to benefit limits and conditions mentionedin Para 11A) and exclusions mentioned in Para 15 below.During one period of 24 continuous hours (i.e. one day) of Hospitalisation (after havingcompleted the 24 hours as above), if the said Hospitalisation included stay in an Intensive CareUnit as well as in any other in-patient (non-Intensive Care Unit) ward of the Hospital, the
    • Corporation shall pay benefits as if the admission was to the Intensive Care Unit provided thatthe period of Hospitalisation in the Intensive Care Unit was at least 4 continuous hours.No benefit will be payable for the first 24 hours of hospitalisation. However, for everyHospitalization that extends for a continuous period of 7 days or more, the Daily Hospital CashBenefit would also be paid for first 24 hours (day one) of hospitalization, regardless of whetherthe Insured was admitted in a general or special ward or in an intensive care unit.B) Major Surgical Benefit: In the event of an Insured under this plan, due to medical necessity,undergoing one of the surgeries defined in Major Surgical Benefit Annexure, within the coverperiod in a hospital due to Accidental Bodily Injury or Sickness, the respective benefitpercentage of the Major Surgical Benefit Sum Assured, as specified against each of the eligiblesurgeries mentioned in Major Surgical Benefit Annexure, shall be paid subject to benefit limitsand conditions mentioned in Para 11B) and exclusions mentioned in Para 15 below.C) Day Care Procedure Benefit: In the event of an Insured under this Plan undergoing anyspecified Day Care Procedure mentioned in the Day Care Procedure Benefit Annexure due tomedical necessity, a lump sum amount equal to 5 (five) times the Applicable Daily Benefit shallbe paid, regardless of the actual costs incurred, subject to benefit limits and conditions mentionedin Para 11C) and exclusions mentioned in Para 15 below.D) Other Surgical Benefit: In the event of an Insured under this Plan, due to medical necessity,undergoing any Surgery not listed under Major Surgical Benefit or Day Care Procedure Benefit,causing the Insured’s Hospitalization to exceed a continuous period of 24 hours within the CoverPeriod, then, a daily benefit equal to 2 (two) times the Applicable Daily Benefit shall be paid foreach continuous period of 24 hours or part thereof provided any such part stay exceeds acontinuous period of 4 hours of Hospitalization, subject to benefit limits and conditionsmentioned in Para 11D) and exclusions mentioned in Para 15 below.E) Ambulance Benefit: In the event that a Major Surgical Benefit falling under Category 1 orCategory 2 (as mentioned in the Major Surgical Benefit Annexure) is payable and emergencytransportation costs by an ambulance have been incurred, an additional lump sum of ` 1,000 willbe payable in lieu of ambulance expenses.
    • F) Premium Waiver Benefit: In the event that a Major Surgical Benefit falling under Category 1or Category 2 (as mentioned in the Major Surgical Benefit Annexure) is payable in respect ofany Insured covered under the policy, the total annualized premium i.e. total one year premiumin respect of that Policy from the date of instalment premium due coinciding with or nextfollowing the date of the Surgery will be waived.G) No claim benefit: A no claim benefit will be paid in the event that during the period betweenDate of Commencement of policy and next Automatic Renewal Date or between two AutomaticRenewal Dates (described in Para 4 below) there are no claims in respect of any Insured coveredunder your policy. The amount of the no claim benefit would be equal to 5% (five percent) of theInitial Daily Benefit in respect of each Insured and the resulting amount shall be added to arriveat the Applicable Daily Benefit in respect of each Insured for the Policy Year next following themost recent Automatic Renewal Date.ii) Benefit Limits and Conditions:A) Hospital Cash Benefit:i) The Hospital Cash Benefit shall be payable only if Hospitalisation has occurred within India.ii) The total number of days for which hospital cash benefit would be payable, in respect of eachInsured, in a Policy Year would be restricted to -a) A maximum of 30 (thirty) days of Hospitalization out of which not more than 15 (fifteen) daysshall be in an Intensive Care Unit in the first Policy Year following the date of commencementof cover in respect of that Insuredb) A maximum of 90 (ninety) days of Hospitalization out of which not more than 45 (forty five)days shall be in an Intensive Care Unit in the second and subsequent Policy Years following thedate of commencement of cover in respect of that Insurediii) The total number of days of Hospitalization for which Hospital Cash Benefit is payableduring the Cover Period, in respect of each and every Insured covered under the policy, shall belimited to a maximum of 720 (seven hundred and twenty) days out of which not more than 360(three hundred and sixty) days shall be in an Intensive Care Unit. Upon attainment of this limitby an Insured, the Hospital Cash Benefit in respect of that Insured shall cease immediately.iv) The Benefit Limits specified in the above clauses in respect of an Insured under this Policy,shall solely and exclusively apply to that Insured. Any unclaimed Hospital Cash Benefit of any
    • one Insured is not transferable to any other Insured.v) The Hospital Cash Benefit shall not be payable in the event of an Insured under this Policyundergoing any specified Day Care Procedure (as mentioned in the Day Care Procedure BenefitAnnexure).B) Major Surgical Benefit:i) If more than one Surgery is performed on the Insured, through the same incision or by makingdifferent incisions, during the same surgical session, the Corporation shall only pay for thatSurgery performed in respect of which the largest amount shall become payable.ii) The Major Surgical Benefit shall be paid as a lump sum as specified for the benefit concernedand is subject to providing proof of Surgery to the satisfaction of the Corporation.iii) All Surgical Procedures claimed should be confirmed as essential and required, by a qualifiedPhysician or Surgeon, to the satisfaction of the Corporation.iv) The Major Surgical Benefit will be payable only after the Corporation is satisfied on the basisof medical evidence that the specified Surgery covered under the Policy has been performed.v) The Major Surgical Benefit shall be payable only if the Surgery has been performed withinIndia.vi) The amount in lieu of ambulance expenses shall be payable only once in respect of eachInsured in any Policy Year and is subject to providing satisfactory evidence to the Corporation.vii) The total amount payable in respect of each Insured under the Major Surgical Benefit in anyPolicy Year during the Cover Period shall not exceed 100% of the Major Surgical Benefit SumAssured in that Policy year.viii) The total amount payable in respect of each Insured during the Cover Period under theMajor Surgical Benefit shall not exceed a maximum limit of 800% of the Major Surgical BenefitSum Assured. If the total amount paid in respect of an Insured equals this lifetime maximumlimit, the Major Surgical Benefit in respect of that Insured will cease immediately.ix) The Benefit Limits specified in the above clauses in respect of an Insured under this Policy,shall solely and exclusively apply to that Insured. Any unclaimed Major Surgical Benefit of anyone Insured is not transferable to any other Insured.x) The Major Surgical benefit for any surgery cannot be claimed and shall not be payable morethan once for the same surgery during the term of the policy.
    • C) Day Care Procedure Benefit:i) If more than one Day Care Procedure is performed on the Insured, through the same incisionor by making different incisions, during the same surgical session, the Corporation shall only payfor one Day Care Surgical Procedure.ii) The Day Care Procedure Benefit shall be paid as a lump sum and is subject to providing proofof Surgery to the satisfaction of the Corporation.iii) All Surgical Procedures claimed should be confirmed as essential and required, by a qualifiedPhysician or Surgeon, to the satisfaction of the Corporation.iv) The Day Care Procedure Benefit will be payable only after the Corporation is satisfied on thebasis of medical evidence that the specified Surgical Procedure covered under the policy hasbeen performed.v) The Day Care Procedure Benefit shall be payable only if the Surgical Procedure has beenperformed within India.vi) In respect of each Insured, the Day Care Procedure Benefit will be payable only up to amaximum of 3 (three) Surgical Procedures in any Policy Year during the Cover Period.vii) In respect of each Insured during the Cover Period, the Day Care Procedure Benefit will bepayable only up to a maximum of 24 (twenty four) Surgical Procedures. If the number ofSurgical Procedures eligible for the Day Care Procedure Benefit in respect of an Insured equalsthis lifetime maximum limit, the Day Care Procedure Benefit in respect of that Insured will ceaseimmediately.viii) The Benefit Limits specified in the above clauses in respect of an Insured under this Policy,shall solely and exclusively apply to that Insured. Any unclaimed Day Care Procedure Benefit ofany one Insured is not transferable to any other Insured.ix) If a Day Care Procedure Benefit is performed no Hospital Cash Benefit shall be paid.D) Other Surgical Benefit:i) If more than one Surgical Procedure is performed on the Insured, through the same incision orby making different incisions, during the same surgical session, the Corporation shall only payfor one Surgical Procedure.ii) The Other Surgical Benefit shall be paid as a Daily Benefit and is subject to providing proofof Surgery to the satisfaction of the Corporation.
    • iii) All Surgical Procedures claimed should be confirmed as essential and required, by a qualifiedPhysician or Surgeon, to the satisfaction of the Corporation.iv) The Other Surgical Benefit will be payable only after the Corporation is satisfied on the basisof medical evidence that the specified Surgical Procedure covered under the policy has beenperformed.v) The Other Surgical Benefit shall be payable only if the Surgical Procedure has beenperformed within India.vi) The total number of days of Hospitalization for which the Other Surgical Benefit is payableduring a Policy Year in respect of each and every Insured covered under the Policy shall notexceed 15 (fifteen) days in the first Policy Year following the date of commencement of cover inrespect of that Insured and 45 (forty five) days for the second and subsequent Policy Yearsfollowing the date of commencement of cover in respect of that Insured.vii) The total number of days of Hospitalization for which the Other Surgical Benefit is payableduring the Cover Period, in respect of each and every Insured covered under the Policy shall notexceed a maximum limit of 360 (three hundred and sixty) days. Upon attainment of this lifetimemaximum limit, the Other Surgical Benefit in respect of that Insured will cease immediately.viii) The Benefit Limits specified in the above clauses in respect of an Insured under this Policy,shall solely and exclusively apply to that Insured. Any unclaimed Other Surgical Benefit on anyone Insured is not transferable to any other Insured.iii) Commencement And Termination Of Benefit Covers:The Hospital Cash Benefit, Major Surgical Benefit, Day Care Procedure Benefit and OtherSurgical Benefit cover in respect of each Insured covered under your policy shall commence onthe Date of Cover Commencement individually stated in the Policy Schedule.The Hospital Cash Benefit, Major Surgical Benefit, Day Care Procedure Benefit and OtherSurgical Benefit cover in respect of each Insured shall terminate at the earliest of the following:i. The Date of Cover Expiry mentioned in the Policy Schedule;ii. On exhausting all the lifetime maximum Benefit Limits as specified in Para 11 above;iii. On death or Date of Cover Expiry of the Principal Insured and if the Policy does not continuewith the Insured Spouse as the Principal Insured;iv. On death or Date of Cover Expiry of Insured Spouse after the Policy continues with the
    • Insured Spouse as the Principal Insured after the PI dies or reaches his/her Date of Cover Expiry.v. On death of the Insured;vi. In respect of the Insured Spouse, on divorce or legal separation from the Principal Insured;vii. On termination of the Policy due to non-payment of premium or any other reason.iv) Termination of Policy:A) If policy is issued on single life:The policy shall terminate at the earliest of the following:i) Non-payment of premiums within the revival period;ii) On death;iii) On the Date of Cover Expiry mentioned in the Policy Schedule;iv) On exhausting all the lifetime maximum Benefit Limits as specified in Para 11 above.B) If policy is issued on more than one life:The policy shall terminate at the earliest of the following:i) Non-payment of premiums within the revival period;ii) On PI exhausting all the lifetime maximum Benefit Limits as specified in Para 11 above.iii) On death or Date of Cover Expiry, of the Principal Insured and if the Policy does notcontinue with the Insured Spouse as the Principal Insured.iv) On the death or Date of Cover Expiry, of Insured Spouse after the Policy continues with theInsured Spouse as the Principal Insured after the PI dies or reaches his/her Date of Cover Expiry.v) Waiting Period:General waiting period:There shall be no general waiting period in case Hospitalization or Surgery is due to AccidentalBodily Injury. There shall be a general waiting period during which no benefits shall be payablein the event of Hospitalization or Surgery, if the said Hospitalization or Surgery occurred due toSickness.i. The general waiting period shall be 90 (ninety) days from the Date of Cover Commencementin respect of each Insured.ii. If the policy is revived after discontinuance of the Cover then the following shall apply in
    • respect of each Insured:a) If the request for revival is received by the Corporation within 90 (ninety) days from the duedate of the first unpaid premium, then there shall be a general waiting period of 45 (forty five)days from the Date of Revival in respect of each Insured.b) If the request for revival is received by the Corporation beyond 90 (ninety) days from the duedate of the first unpaid premium, then there shall be a general waiting period of 90 (ninety) daysfrom the Date of Revival in respect of each Insured.Specific waiting period:In addition, in respect of each Insured, no benefits are available hereunder and no payment willbe made by the Corporation for any claim under this Policy on account of Hospitalization orSurgery directly or indirectly caused by, based on, arising out of or howsoever attributable to anyof the following during the specific waiting period:i. Treatment for adenoid or tonsillar disordersii. Treatment for anal fistula or anal fissureiii. Treatment for benign enlargement of prostate glandiv. Treatment for benign uterine disorders like fibroids, uterine prolapse, dysfunctional uterinebleeding etcv. Treatment for Cataractvi. Treatment for Gall stonesvii. Treatment for slip discviii. Treatment for Pilesix. Treatment for benign thyroid disordersx. Treatment for Herniaxi. Treatment for hydrocelexii. Treatment for degenerative joint conditionsxiii. Treatment for sinus disordersxiv. Treatment for kidney or urinary tract stonesxv. Treatment for varicose veinsxvi. Treatment for Carpal tunnel syndromexvii. Treatment for benign breast disorders e.g. fibroadenoma, fibrocystic disease etc
    • The specific waiting period in respect of the treatments specified in the list above shall be asfollows:i. The specific waiting period shall be 2 (two) years from the Date of Cover Commencement inrespect of each Insured.ii. If the policy is revived after discontinuance of the Cover then the following shall apply inrespect of each Insured:a) If the request for revival is received by the Corporation within less than 90 (ninety) days fromthe due date of the first unpaid premium, then the specific waiting period shall continue to be till2 (two) years from the Date of Cover Commencement in respect of each Insured.b) If the request for revival is received by the Corporation beyond 90 (ninety) days from the duedate of the first unpaid premium, then there shall be a specific waiting period of 2 (two) yearsfrom the Date of Revival in respect of each Insured.No charges for this benefit shall be deducted after the benefit ceases.Benefit Illustration :SECTION 45 OF INSURANCE ACT, 1938:No policy of life insurance shall after the expiry of two years from the date on which it waseffected, be called in question by an insurer on the ground that a statement made in the proposalfor insurance or in any report of a medical officer, or referee, or friend of the insured, or in anyother document leading to the issue of the policy, was inaccurate or false, unless the insurershows that such statement was on a material matter or suppressed facts which it was material todisclose and that it was fraudulently made by the policyholder and that the policyholder knew atthe time of making it that the statement was false or that it suppressed facts which it was materialto disclose.Provided that nothing in this section shall prevent the insurer from calling for proof of age at anytime if he is entitled to do so, and no policy shall be deemed to be called in question merelybecause the terms of the policy are adjusted on subsequent proof that the age of the life assuredwas incorrectly stated in the proposal.
    • SECTION 41 OF INSURANCE ACT 1938:(1) No person shall allow or offer to allow, either directly or indirectly, as an inducement to anyperson to take out or renew or continue an insurance in respect of any kind of risk relating tolives or property in India, any rebate of the whole or part of the commission payable or anyrebate of the premium shown on the policy, nor shall any person taking out or renewing orcontinuing a policy accept any rebate, except such rebate as may be allowed in accordance withthe published prospectuses or tables of the insurer: provided that acceptance by an insuranceagent of commission in connection with a policy of life insurance taken out by himself on hisown life shall not be deemed to be acceptance of a rebate of premium within the meaning of thissub-section if at the time of such acceptance the insurance agent satisfies the prescribedconditions establishing that he is a bona fide insurance agent employed by the insurer.(2) Any person making default in complying with the provisions of this section shall bepunishable with fine which may extend to five hundred rupees.Note: Conditions apply for which please refer to the Policy document or contact our nearestBranch Office.